Question
What is the chance I will not need treatment within 5 years?
24 November 2008. Related: All topics, CD4 and viral load, Newly diagnosed, Starting treatment.
I was recently diagnosed with HIV a few weeks ago after being told by an ex-partner that he had tested positive. I contracted HIV from him approximately 12 weeks ago, so I understand that I am still in primary infection phase.
I recently obtained my blood test results showing a CD4 count of 522 and viral load of 55,000. Although these really just numbers for me, I guess I expected my results to be a bit better as I am only 23. I understand that treatment is recommended once CD4 count approaches 350, and I am worried about how soon I may need to start treatment, as the information I had read suggested that on average, treatment usually starts 8-9 years down the track.
I guess I just would like to know where i fit in with regards to 'the norm'? I know that everybody is different, but are my results 'normal' or would one expect them to be a bit higher considering that I am quite young and in fairly good health?
What are the chances that I will not require HIV meds in the next 5 years?
On average, how long after infection do people require medication? Thanks.
Answer
Hi Robert
You ask a lot of important and normal questions.
I’m sorry to hear about your recent diagnosis, which I’m sure must be difficult to get used to.
Although one set of blood results can’t tell you very much, your counts within the ‘normal range’. What becomes more important is building up a picture from several sets of results over the next few months.
You are right that there is such a wide range of responses, that it is more important to focus on your own results.
Earlier this year, an interesting study from the UK of people diagnosed with early or recent infection reported that the average time people took for their CD4 counts to start treatment (excluding those who started within the first 6 months) was about 5 years. However, 25% of people needed to start within 2 years of infection and another 25% hadn’t started after over 10 years.
The two main point here are that i) people probably start treatment a few years earlier on average but that ii) there really is a wide range of individual responses.
Luckily, even if you need treatment earlier, you are likely to get just a good response. The pace that HIV progresses has no relationship to your likelihood of getting a good response once you start.
Based on the above study, the chance is exactly 50:50 that you will need (or not need) treatment in 5 years.
The chance may be slightly higher now the guidelines for starting treatment are 350 rather than 200 copies/mm3.
If it is useful to talk about any of this, then please giv the phoneline a call.
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